Saturday, April 12, 2008

Giving birth



So it turns out that Misconceptions: Truth, Lies, and the Unexpected on the Journey to Motherhood has a younger, more even-tempered little sister. She is Giving Birth: A Journey into the World of Mothers and Midwives. Granted, author Catherine Taylor stays far away from the wider social commentary that was so irksome to me in Naomi Wolf’s book, so perhaps there is just less to annoy me with in her subject matter to begin with.

Still, I found Giving Birth to be a very interesting, if not always fascinating – and certainly not as fascinating as Baby Catcher – “journey,” if you will, into, you guessed it, the world of mothers and midwives. As with most any book, I found I had to accept from the beginning that some of the author’s opinions would not agree 100% with my own. But that’s the point of reading books like these, isn’t it? I was curious about this woman’s experience shadowing midwives, becoming a doula, and eventually giving birth to her second child at home (that last part should probably have a spoiler warning. Sorry).

My in-your-face-feminist radar started tingling early in the first chapter when I read this sentence, in which the author is trying to explain how she was feeling when she decided she wanted a second child:

“I wanted to be special, taking up space in the world, my power written on my body, people smiling at my belly, holding doors, and offering seats (even as I want to reject the stereotype of the weak female).”

That parenthetical aside seems absolutely wedged in there, like it’s actually the main message of the chapter instead of, well, a parenthetical aside. I am more than happy to let her preach about her own sentiments in what is, after all, her own book – but this felt like shoving it down my throat.

Fortunately, it got better from there. Ms. Taylor gives us a very interesting behind-the-scenes look at modern midwifery practices in America, and modern attitudes about birthing from a wide range of women. She draws heavily on personal interviews and gives away entire paragraphs to quotes from her real-life characters, often not interrupting with editorial comment at all. In many ways, it is like a documentary in book form. A few narratives are followed from beginning to end, interspersed with smaller segments of stories that serve to illustrate key points.

One of those key points is that home birth is safe. Specifically:

“[R]esearch has shown time and again that, statistically, home birth for a healthy woman, attended by a qualified individual within a system that allows for hospital backup when necessary, is as safe as or safer than birth in the hospital.”

I believe her when she says this. In fact, I believed her every single time she said it in the book, which was probably more than a dozen times. However, cited research notwithstanding, the claim takes on just a tinge of disingenuousness because when you think about it, the process of deciding to home birth self-selects the kind of woman who is going to have a successful birth outcome. She is almost certainly educated about the birthing process, healthy throughout, and determined to make it work. Also, high-risk pregnancies/births similarly self-select to take place in a hospital – thus raising their rates of less successful outcomes.

Another statistic Ms. Taylor is fond of citing - that of America’s seemingly abysmal infant mortality rate, especially when compared to European nations who rely on a less medicalized model of childbirth – is skewed for this same reason. America’s childbearing population is probably much more diverse (and thus unhealthy, or high-risk, or whatever) than any of the childbearing populations in these countries. Also, it could be argued that US obstetricians are more often involved in extremely risky births that may not even be attempted elsewhere in the world. Again, these mitigating factors receive no attention from the author.

The subject of epidurals comes up often and it is, of course, a divisive one. After 24 hours of labor with Miriam, I finally had one administered, and there are times when I feel guilty about it. I at least have the consolation (?) that it had worn off by the time I was pushing, with the additional bonus that I was able to walk to go to the bathroom by myself shortly after delivering (woohoo!). Do you see how I feel like I have to justify it to you? There really is no reason that I should feel guilty about it – no one I know, even those who have delivered without drugs, has ever made me feel that way. But on some level, I still appreciated the validation I received from Ms. Taylor when she said,

“Still, [my doula instructor] is careful to begin by pointing out times when epidurals are worth the risks, including sheer exhaustion and discouragement, extremely long early labors, when labor is really stuck, if you’ve tried everything else and you still need help, if you have a caesarean, or induction when the cervix is not ripe.”

I read this and almost laughed as internally, I checked off each of these factors, save one (no C-section, thankfully) as being present at my labor with Miriam.

Finally, I was glad to read several accounts of home birth by someone who was at first fairly removed from the process. (Baby Catcher is full of home birth accounts, but they are almost all given by the midwife who was attending.) It is amazing to me to observe the evolution of my opinion on home birth. It wasn’t even on my radar until my good friend Kristen had a beautiful home birth experience at the end of 2006. At the time, I thought it was kind of strange, but good for her. Somehow, over the past year and a half, I have really come to appreciate at least the thinking behind home birth, if not the actual practice itself, at least not for myself. That’s why I am so glad to have a freestanding Birth Center here in Tucson – it provides a sort of “in-between” option for those of us who embrace the general philosophy behind home birth without necessarily wanting to scrub birth mess off of our own bathroom floors (I’m being completely facetious with that last bit, Kristen and Sarah!).

If you’ve already read books like Birth (a must!) and Baby Catcher, Giving Birth is another one to add to the pile. It is a fresh look at the same old thing, and it also has the dubious distinction of being the first book I’ve ever read that features a woman’s bum cleavage on the front cover. Perhaps you can’t say the same?

11 comments:

Crys said...

I always appreciate when people are able to break down the problems with facts and stats! So many people in this country just look at what is written or what the media tells them and never question that information may be being misrepresented a bit to make the argument stronger. What can I say. I'm a born cynic and I appreciate the questioners! Anyway I too feel a little guilty about my epidurals. No one has every said anything to me but I guess in the back of my mind I have nagging doubts that I'm not as strong as I wish I could be. To be honest though I held out 36 hours with little man E and I think that was probably 12 hours too many :) As for Graceland I was over a seven when I got it and I have to say that I was up and about, walking down the halls driving the nurses nuts that evening. So I think I can feel ok about that as well. I do toy with the idea of a natural birth the next time around. My friend has told me some good things about hypnobirthing, but I will definitely be at the hospital with Dr. J delivering. My aunt had all her kids at home and so did my mom's best friend and it was cheap and nice for them but our town house is small, and the idea of having to look at Dr. J's white board and messy desk while I push our child into the world and then having to clean up afterbirth off our gray blue carpet is just not appealing to me :)

Sarah Rose Evans said...

You've tackled the prefect pregnancy reading list-- it's been interesting to see all these books that I read and found inspiring during my labor appear on your blog, one by one. I can't remember if you've checked out Ina May Gaskin yet, but she's great, too. I LOVED Babycatcher-- I thought it was the most helpful of all the pregnancy books I read. And Misconceptions was the book that made me want a home birth in the first place-- actually, I wanted a birth in a freestanding birth center. But when we interviewed a midwife at the one in Portland, we hated her. ("There's really no such thing as post-partum depression," she said, "So if you feel bummed out, just go for a walk in the sunshine.") Anyway, I feel really good about my birth. The experience was really empowering, even though my midwife was MIA for most of my labor. I have such positive feelings about Demitri's birth, it really bums me out when I hear about women who have less positive feelings. I hope your next birth is uncomplicated by sheer exhaustion and discouragement, extremely long early labors, and getting stuck.

Liz Johnson said...

If I were going to read this book or BabyCatcher, which would you recommend? I might read both, but I'm getting a little burnt out on pregnancy books, so I thought I'd get your recommendation on which is better. :)

Aimee & Fam said...

Hi Bridget, I happened upon your blog a couple weeks ago via another friend from WHS. I then proceeded to read ALL of your blogs. It took all afternoon. I wanted to let you know that I delivered at a birth center in Portland, OR a little over a month ago, and it was an absolutely amazing experience. A happy median between hospital over medicalization and home-birth. I had a very long, exhausting labor that was worth going through any day! I would do it again in a heartbeat. For another good "birth book" try Ina May's guide to childbirth. You might enjoy analyzing it as well! Good luck!

Aimee Shawcroft Archer

Aimee & Fam said...

Oh, and an aside to Sarah. I am unsure which birth center in Portland you checked out, but the one I delivered at was called: Andaluz Waterbirth Center at www.waterbirth.net There are many different midwives there all with differing philosophies. I am certainly not "earth mother-esque," and they respected that fully. Maybe for your next birth you can check them out. Everyone I know had an amazing if not intense experience there.

Bridget said...

Liz - definitely Baby Catcher. But get ready for some wild stories. Also, there are a couple of accounts of stillbirths near the end of the book, in case your pregnant self would find that disturbing.

Kristen said...

Thanks for the shout-out Bridget, I feel famous.

My brother owns a carpet cleaning business. He had the pleasure of attempting to remove the "birth mess" from our Memory Foam Mattress. Awkward. But it was purely the result of a faultily-crafted birthing blanket, in which the mess should have contained (yeah, I made it, so what?).

I do love your literary analysis, it is always incredibly insightful. Thank you for sharing your wisdom with all of us.

I also want to second Crys' comments about people blindly following media propaganda and "documentaries" (which are, by definition, not supposed to be fictional). Living in a Bush-bashing Hippie-town can be irritating. And this coming from a home-birth freak, I know it is strange.

Jeanerbee said...

I wish there was a birth center where I will be living! I could really do without the interference of the hospital staff next time around. There is one about an hour from where we will be, and I'm seriously thinking of making the drive. The website said they even had massage therapy available during labor - can you believe that???!!! Home birth is kind of my secret dream though, lol. I just always have that "what if" worst case scenario in my mind. Thanks for the book rec's!

Bridget said...

Sarah, one of these days I want to hear all about your birth experience. I ended up only hearing pieces of it second-hand through various sources, so I don't know quite how it all fits together.

Aimee, the fact that you can already say you would do it again in a heartbeat is awesome! It took me two years to be able to say that :). Did you end up having an actual waterbirth or is that just the name of the center?

Kristen, your story about the birthing quilt is actually one of the funnier things I've ever heard. I hope you don't mind me saying that. I mean really, what else did we learn at YW activities except that if you make a quilt, you tie it???

Nine, you should totally look into it. An almost-hour drive is nothing!

Aimee & Fam said...

It was a waterbirth and I lived in the 300 gallon bathtub through my whole labor, they call it the natural epidural, and I found that to be true. I got out occasionally to make use of gravity. To be perfectly honest, I don't think there is any way I could have done a "natural" birth in a hospital. I would have been clamoring for the pain killer. Because Jameson was 11 pounds 4 oz he did need some help getting out, so I was out of the tub for that part of the birth, unfortunately. Our next one won't be two weeks late, if I can help it.

SharTrevHarp said...

Have you seen the documentary "The Business of Being Born"? It is an excellent review of birth in American hospitals and a perspective on home births--produced by Ricki Lake. I've read several of the books you've reviewed on your blog & found them all quite helpful! My husband & I are gearing up for a 'natural birth' sometime in June and trying to get as much info as possible. Thanks for your thoughts!
-Shara (Jen Jackson's sis-in-law/fellow FLSR-er)

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